Artikel
Good shoulder function, but high rates of instability recurrence and revision surgery 20 years following arthroscopic Bankart repair for the treatment of anterior shoulder instability
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Autoren
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Lucca Lacheta
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Romed Peter Vieider
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Kristina Zauner
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Johannes Plath
- OFZ Weilheim, Weilheim, Germany
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Moritz Brunner
- München, Germany
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Bastian Scheiderer
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Andreas B. Imhoff
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Sebastian Siebenlist
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Sebastian Lappen
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
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Maximilian Hinz
- Sektion Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
| Veröffentlicht: | 21. Oktober 2024 |
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Gliederung
Text
Objectives: Previous studies have shown that arthroscopic Bankart repair (ABR) for the treatment of anterior shoulder instability (ASI)may lead to high rates of instability recurrence and revision surgery at 10-year follow-up, but data on 20-year postoperative outcomes are scarce.
The purpose of the present study was to evaluate the clinical and functional outcome after ABR for the treatment of ASI at long-term follow-up. It was hypothesized that ABR would be associated with high rates of revision surgery, re-instability and re-dislocation, but good to excellent shoulder function.
Methods: Patients that underwent ABR for the treatment of ASI and were previously followed up minimum 10 years postoperatively were eligible to participate. Minimum 20 years postoperatively, the rates of revision surgery, re-instability (without re-dislocation) and re-dislocations, patient-reported outcome measures, including the American Shoulder and Elbow Surgeons (ASES) Score, Constant-Murley Score (CMS), and visual analog scale (VAS) for pain and instability at rest and during activity were evaluated.
Results and conclusion: In total, 83 patients were followed up, of which 16 patients (19.3%) underwent revision surgery, 12 patients (17.9%) reported re-instability and 9 patients (13.4%) suffered re-dislocations. In patients that did not undergo revision surgery, shoulder function was good to excellent (ASES Score: 95.0 [89.0-100], CMS: 88.0 [77.0-95.0]). Low levels of pain and instability were observed at rest (VAS for pain: 0 [0–1.0], VAS for instability: 0 [0–1.0]) and during activity (VAS for pain: 1.0 [0–2.0], VAS for instability: 1.0 [0–3.0]). Multidirectional laxity was associated with postoperative re-instability (odds ratio, 6.717 [95% CI, 1.318–33.979, P = .021). The use of fewer suture anchors for ABR was associated with re-dislocations (no re-dislocation: 3.0 [IQR, 3.0–4.0)]; re-dislocation: 3.0 [IQR, 2.0-3.0], P = .015).
Good to excellent shoulder function as well as low pain and instability levels were observed minimum 20 years after ABR, although about one in three patients reported instability recurrence of re-dislocations and one in five patients underwent revision surgery. The presence of multidirectional laxity was associated with a higher risk for postoperative re-instability and the use of fewer anchors was associated with postoperative re-dislocations.
